Feeling depressed, lonely, aimless - need help figuring out my life
September 21, 2014 5:47 PM   Subscribe

I'm at a point where I just don't know what to do - I feel hopeless, aimless, and lost; I feel like there's little hope for my life getting better, and that I'll spend the rest of my life alone, just doing... nothing meaningful. I need help.

About a year ago, I changed jobs, moved to California (from New York) and got divorced, all over the span of several months. My divorce was relatively amicable but painful; I actually initiated it, for various reasons, but primarily because my husband was cold, and at times emotionally abusive, and a potential romantic interest from a friend gave me the strength (or the stupidity?) to finally leave the marriage. My now ex told me that no one else would ever love me, that I would be all alone now. And, as it happened, the other relationship didn't work out. And so I found myself living across the country, feeling sad, lost and home-sick, hating my new job and grieving my divorce and life choices. So I decided to move back.

Now it's a year later, and I've moved back to NY. I have job I like, though don't love - but it's ok for right now; I have a great apartment; I'm closer to my parents and some friends. But that hasn't really changed how I feel - I'm still depressed, still feeling aimless and hopeless, like my life is just going nowhere. Sometimes I have ideas - like an interesting class i'd like to take, or a meet up group, or an idea for a short story; but usually within a day or two that interest fades away and i'm back to feeling depressed. There are days that I only leave my apt to walk my dog, or just to go to work; sometimes I wake up and feel like i'm going to suffocate in the hopelessness. Even things I used to really enjoy - writing, going to the movies, etc - I can barely bring myself to do; it all just feels meaningless. Sometimes I make plans with friends, and then I often cancel them because I can't bear to go outside or talk to people. I've been seeing a therapist has helped somewhat but I still feel terrible. What should I do? How can I get over these feelings of despair? I would appreciate any advice - I don't want to spend the rest of my life living like this.
posted by nightdoctress to Human Relations (28 answers total) 25 users marked this as a favorite
I'm so sorry you are having such a hard time. It sounds like you've been through a lot of changes and it's only natural to feel a bit aimless (Really, not that much time has passed). It sounds to me like you're dealing with some classic depression symptoms. Good on you for getting into therapy but have you considered also adding a psychiatrist and possibly antidepressants? Therapy is sort of like ... surgery, for lack of a better analogy. The surgery is ultimately going to make you feel much better but in the meantime, the doctor might prescribe a painkiller, or muscle relaxant or physical therapy to help with the pain. That's sort of what anti-depressants can do ... keep you feeling better until the therapy kicks in. I really hope you'll consider it. (Also, I'm sure more insightful folks will offer you more pointed advice but please, don't beat yourself for leaving an emotionally abusive marriage. Nothing good could have come of that and God knows, it could have possibly gotten worse. You did a good thing. Let me repeat: You did a GOOD thing.
posted by nubianinthedesert at 6:02 PM on September 21, 2014 [1 favorite]

I've been in this same spot. Divorce is hell even when it goes well. Honestly, meds (with quality therapy) truly helped me get past the hump, and thus able to do things that eliminated the depression.
posted by stowaway at 6:02 PM on September 21, 2014 [1 favorite]

What your ex said is bullshit. Consider the source.

Going through all those stressful life changes at once is very tough, and it is understandable that you would feel depressed.

You could try sticking with those ideas that have given you glimmers of interest, and follow through on taking the class or writing the short story even after the interest fades away. Because you never know, it might be cyclical--the interest might fade back in after a while. And even if you never regain that feeling of being interested, your life will feel more meaningful if you can point to a class or short story and say, "I did that."

Hard exercise can help, too. Can you run with your dog sometimes?
posted by Bentobox Humperdinck at 6:03 PM on September 21, 2014 [4 favorites]

Response by poster: Nubianinthedesert - I have thought about anti-depressants; the problem is my job. I'm a physician, and any psychiatric history or medications go on your record, and it's hard to apply for other jobs in the future because it has to be disclosed. I pay for my therapy out of pocket instead of using my insurance just so that I can keep it private. For me it would unfortunately have to be a last resort.
posted by nightdoctress at 6:05 PM on September 21, 2014

OP, is the the issue you are concerned about a disclosure of your psychiatric history to an employer (which may violate the ADA) or to the state licensing board (in which case, presumably, only the license review board would know)?

Not to derail, but in the legal profession, licensing boards look more favorably on folks who recognize, treat, and manage things before they get out of hand (inappropriate substance use, violence, DUIs, emergency psychiatric admission, etc.)
posted by Schielisque at 6:21 PM on September 21, 2014

My sister is a physician too. A few years ago she was going through a stressful period and somehow ended taking zumba classes three or four nights a week. She's never done anything like that before and it ended up really helping her put a more positive spin on her life. It made her feel stronger and more flexible physically and somehow that carried over to her emotional life.

If you can, sign up for some kind of movement class, something upbeat with music, and take your dog for longer walks, walk as fast as you can for at least 45 minutes every day and walk in the park or by the river. Make sure you're out in the sunshine whenever possible. Get your vitamin D levels checked. Spend as much time as you can outdoors in beautiful settings. Go upstate for the weekend and see the foliage. Go to a different museum every week, in NY you've got plenty.

Divorce is like a death and there's no set time for how long it takes to grieve. Don't be hard on yourself.
posted by mareli at 6:23 PM on September 21, 2014 [4 favorites]

I'm sure you are taking Vitamin D, right? Because my husband went into the hospital over a Vitamin D deficiency. We both take 5,000 IU a day.

Yes, your ex is a piece of shit and no, don't take in what he said to you. You're gone from him now, don't let him have rent space inside your head, criminy. You're very lovable.

Do you exercise every day? Beyond the dog walking? I've been to therapy and #1 is exercise, hard exercise. Don't want to go outdoors? Walk Away the Pounds. Sounds cheesy, but it works.

You need a routine: get up, walk the dog, shower, eat, exercise, work, dog again. Supper, friends/family, fav TV shows. Bed by X. Read a mindless book in bed, with a lamp on, no computer in bed. Keep at it. Eventually, you will feel good and safe and yes, you are very lovable, and no, it won't last forever. {{{{{hugs}}}}}
posted by Marie Mon Dieu at 6:59 PM on September 21, 2014 [5 favorites]

OP, I'm an (unlicensed) law school grad. If I were to apply for bar admission, I'd be forced to disclose my psychiatric history. I am positive, though, that I would not be the first attorney to seek such help. I'm sure you won't be the first physician and I feel confident saying that this would not affect your employment prospects. However, being seriously depressed and anxious and unable to perform your duties would.
posted by nubianinthedesert at 7:09 PM on September 21, 2014 [4 favorites]

I have friends who are doctors and very open about their antidepressant use. It does not have to be a big deal.
posted by stowaway at 7:31 PM on September 21, 2014 [4 favorites]

Don't want to thread hog but I just had another thought (Doesn't happen often. :) )What is the quality of your support system in NYC? You mentioned that you are now closer to family but is that a good thing? Are your friends aware of the situation you were in? I ask because I wonder if you might benefit from sort of women's support group or support group for divorced people/abuse survivors? Many hospitals offer these for free and I know NYC has to have plenty somewhere in those five boroughs.
posted by nubianinthedesert at 7:51 PM on September 21, 2014

Response by poster: Thank you for the replies... i'll think about the antidepressants. Another concern I have about taking them is that i'm a creative person - once upon a time I was a writer - and even the thought of maybe writing again gives me a tiny bit of hope. I'm concerned that taking any psychotropic meds would "dull" me. I can try Vitamin D; i've already tried other supplements to help me sleep (I was having panic attacks for a while, though those have stopped thankfully), so maybe that will help.

Nubianinthedesert - my support system is ok, my parents are trying to be supportive (they weren't at first) and my friends are generally there when I need them. My mother has severe anxiety so I can't really share anything serious with her without her having a mental breakdown (not exaggerating - when I first got divorced my dad had to take her to the ER because she had such a severe panic attack). Part of the issue is that i'm not an extremely social person to begin with, and feeling the way I do has made it so much worse. My ex used to make fun of my awkwardness and now that I have to face social situations alone, it's even more difficult. Today, for instance, it was a beautiful day and I took my dog to the park; but walking around, amongst people that were having a good time, out with their families, kids, etc., just made me feel even more isolated and like I just don't belong, because I've messed up my life so much. I know it probably sounds ridiculous, but when i'm around other people all I want to do is hide; aside from a few close friends, the only time I've really been socializing is at work, because I have to.
posted by nightdoctress at 8:10 PM on September 21, 2014

Try some fish oil tablets first; that, and as much sunlight as you can stand. Also, spin class or Zumba or something like that.

I speak from experience. That WILL help, whether or not you try an antidepressant. And honestly, if this is the first time you have been depressed, you aren't going to have to take them forever. Just to get over the hump of how you feel.

Also, prayer can't hurt.

Oh, I almost forgot-when I was going thru my worst times, journaling was quite a literal godsend. To put good pen to good paper felt good in itself-to get my thoughts outside my head and onto that good paper was even better. It helps with perspective.

You are depressed. In your circumstances that is to be expected. But you won't always feel like this. And again antidepressants are not the end of the world-they can be a temporary help that can help you get through the worst of things and back to enjoying life once more. Nothing to be ashamed of-half the world is on them, it seems! I used to be but haven't been for years, so it's not a life sentence!
posted by St. Alia of the Bunnies at 8:22 PM on September 21, 2014 [3 favorites]

How do you feel about volunteering somewhere?
posted by aniola at 8:25 PM on September 21, 2014

Response by poster: Aniola - I actually just volunteered in Ghana for two weeks on a medical mission; the problem is that the NGO I went with is run by the friend/prior love interest, so the experience was emotionally difficult. My ex also called me just last week with a proposal to go volunteer/ teach medicine in Ukraine, which kind of made my depression worse - I guess it shocked me that he would think it's a good/ reasonable idea for us to go to Ukraine or even work on a project together, given the circumstances, and emphasized for me that he must have things so much more together than I do, which is probably what caused my latest bout of hopelessness (now that I think about it)... Even writing this, I'm realizing that i'm probably causing some of my own despair by being in touch with these people. Sigh.
posted by nightdoctress at 8:39 PM on September 21, 2014

Ask your therapist about the meds situation. Doctors are renowned (rightly or wrongly) for having lots of stress and self-medicating in unhelpful ways. I have a hard time imagining why there would be further incentive to discourage medical professionals from getting professional medical help. It's just dumb.

That said, if you want to go the non-prescription medication, there is some promising research on St John's Wort. You need to be careful, it doesn't play well with other medication (not just psych meds, even other stuff) but it's worth reading up on a bit. Vitamin D can be very helpful, as someone else suggested.

I used to be very worried that going on anti-depressants would turn me into some kind of uncreative shell of myself, with few emotions. Because of course, I was doing so well with crippling misery and so much inertia that it was difficult to muster enough enthusiasm to get out of bed. A common experience is that meds just make it harder to get stuck in a rut. They help you out a bit. They don't change you, they don't turn you into a zombie. If they do, they are not the right meds. They just reduce the level of difficulty somewhat.

But all of these kinds of things are just tools to assist. Yes, stop talking to your ex, who is clearly no good for you and is actively trying to sabotage you and make you feel bad. Probably better to steer clear of this romantic friend too. Although throwing yourself into looking after people in even more dire straits than you is certainly a noble endeavour, you also need to put your own oxygen mask on first.

Focus on looking after yourself. Make friends with yourself. Be kind to yourself. Forgive yourself. Do nice things for other people too, especially others in your support network. But it's ok to draw in a little and do what you need to in order to get over this bad patch.
posted by Athanassiel at 9:02 PM on September 21, 2014 [3 favorites]

Another concern I have about taking them is that i'm a creative person - once upon a time I was a writer - and even the thought of maybe writing again gives me a tiny bit of hope. I'm concerned that taking any psychotropic meds would "dull" me.

If you're in so much despair that you're not doing any creative writing now, and meds can take the edge off that despair and at least get you writing "dull" material, that is a step forward from here. It doesn't have to be all-or-nothing; tip-top sharpest writing or no writing at all. Take a middle ground if you can get it, as a stepping stone.

I would think that as a physician, you have access to good databases where you can research the meds and see that any "dulling" effects would wear off after you stop taking them? Maybe that would reassure you that you can take them for a while to get yourself moving.
posted by Bentobox Humperdinck at 11:05 PM on September 21, 2014 [1 favorite]

But that hasn't really changed how I feel - I'm still depressed, still feeling aimless and hopeless, like my life is just going nowhere.

Well, first of all, it's only been a year. And from your later updates, you've had a lot of contact with this ex, so I wouldn't even call it a year. You need a good chunk of time to heal and every time you're in touch with this person (let alone spending two weeks in Ghana via that person's NGO) re-opens the wound and resets the clock. It's not necessary for every breakup but in your case I would say you have to go no contact.

In terms of the possibility of taking anti-depressants, I think you need to evaluate what impact disclosure actually has.

My now ex told me that no one else would ever love me, that I would be all alone now.

Well, fuck him. What a dick. Why are you speaking to this person?

You know, you have a valuable and meaningful job (even if it doesn't feel that way.) And frankly, doctors are generally seen as being a good catch, so just because your last relationship didn't work out doesn't mean you are going to be Forever Alone. After you go no-contact, I'd try online dating, just for something to do.

But more importantly than that, I'd examine with your therapist why you seem to think your value is wrapped up in being in a relationship. Because it's not, and that thinking is going to be nothing but self-destructive.
posted by DarlingBri at 11:05 PM on September 21, 2014 [2 favorites]

You sound like you are classically depressed, and making inescapable circular rationales why things can't change. I would bet 20% of your fellow docs have been on some sort of mood stabilizer at some time in the past or present. Is having a note on your record worse than losing your job or life from untreated depression? What would you say to a patient who was in this situation? I doubt it would be 'do a lot of Zumba'. Go to a professional and get checked out, and don't leave any treatments off the table.
posted by benzenedream at 11:30 PM on September 21, 2014 [4 favorites]

Best answer: It sounds like you are in a stable situation, close to your family and working a job you don't hate. Not to belittle your pain at all, but you should try to find some comfort in the good things you've got going on and use this relatively uneventful time to figure out the kind of life you want to lead.

Again, I am not minimizing your suffering and this isn't meant as some dismissive "first world problems" BS. I know how suffocating depression can be. But you have to try and appreciate that right now you have a home and money and people who love you, you aren't in desperate trouble with the IRS and you don't have a tumor and you're not nursing a dying parent or any of the other awful things that can and eventually will go wrong in this life. You have found yourself shelter in the storm. You are safe. You are feeling lost, but you aren't truly lost. You are safe.

You have so much power right now. You decide what you're going to do for a living. You decide if you chuck it all and go to Borneo. You decide who gets to be your friend. You don't have people depending on your paycheck and you don't have some asshole husband abusing you. You have got the power to make your life whatever you want it to be, and nobody can say shit about it. That's a scary, lonely thing, but it's also an amazing place to be. You are free. You are safe, and you are free.

When you're dying, you know there will be shit you look back on and regret never doing. Try and do that shit, right now.
posted by Ursula Hitler at 1:04 AM on September 22, 2014 [2 favorites]

Seconding Ursula Hitler. You are a doctor! You heal people with the power of your mind (and modern drugs, diagnostic tests, and devices). That's pretty amazing.

But I know depression is awful and doesn't really care what you have and what you do. I've been depressed in this way.

I get the feeling from your post that you are VERY lonely. I think addressing that is the most important thing. You have a good job, parents, friends, etc. -- but I think you really feel a void of connection. Maybe there is a very accepting community you can join (church, activist group, community theatre, volunteer work) that will take you in and give you some love. Or go where you have found a deep connection before to something spiritual and important. Maybe a place? Maybe an old friend from years ago?

It's just a feeling I get from your post, that that would be the most helpful thing of all.
posted by 3491again at 1:49 AM on September 22, 2014 [1 favorite]

I know you said you said you've been volunteering but why not try volunteering with people you don't know (i.e. not your ex)? I've been through a few periods of depression in my life and volunteering/giving myself to others was what I could rely on to get me out of feeling blue. I just felt so more fulfilled when I was doing something for others.
posted by defmute at 4:48 AM on September 22, 2014

Also, volunteering helped me get out depression because I felt like I was a part of a community (my volunteer team). When I was depressed I was very lonely and you as well sound lonely too and for me feeling like I belonged somewhere was the best cure for loneliness. I found that through volunteering and church. If you're not religious (which I am not) there's the Universalist Unitarian church. The UU church is all the best parts of church (community, nice people, free food) but no religion. It's basically a community meeting place where one goes to hang out with nice people.
posted by defmute at 5:01 AM on September 22, 2014

I can only offer anecdotal advice but my family is chock full of physicians, PAs, and nurses (including some that serve on hospital boards, ethics boards, or are chiefs of their departments) and all are supportive of antidepressants as they would be for any other medication for an illness, no judgment.

I personally had to try a few things - Zoloft was kind of a bust (no big changes) but Wellbutrin/its generic have been amazing! I started writing and drawing more and was happier with the results. For me, Wellbutrin makes me feel like the "real me" - not happy (I can still be sad or upset) but not dulled nor full of despair. I think of it as cutting through the soggy shroud of depression (clammy, dulling, making me feel worthless) so the authentic me comes out.

Good luck to you!
posted by pointystick at 5:09 AM on September 22, 2014

There's a degree of familiarity that can go with exs, especially when blue.. but it doesn't help you move forward. Have you considered whether you might have ptsd symptoms? Some hyper-vigilance now?

Socialising isn't going to be harder withouy the ex clawing away at you. It's history and residue telling you lies. That shit the ex said? Was just a control strategy, read up about abusers about and you'll see they all use identical lines.. so not it's not a reflection on you in the slightest.

Try and spend your down time not giving out I reckon - as you do that in your day job and there's only so much emotional energy. If you're going to volunteer or whatever, look for something that exercises your creative muscles. I'd think twice about net dating when feeling vulnerable, but I'm not a fan.
posted by tanktop at 7:41 AM on September 22, 2014

Best answer: Firstly, sorry to hear that things have been difficult recently. Secondly, that's really messed up that seeking medical intervention for a mental health problem still carries such a stigma even within the medical profession itself.

I can only speak as someone who has battled with depression for years, and the longer it has been a part of my life, the more I realise that "depression" is a really unhelpful term. It covers a broad base of emotional and mental states as to be about as useful as saying you have a "leg problem". We don't have this issue in treating physical health problems. You don't have a leg problem, you have a bruised shin, a fractured ankle, bowed legs. These are lay terms, but the medical terms become even more granular in detail. They tell you exactly where the problem is, what caused it and the severity of the trauma and thus what level of intervention is needed. Unfortunately we're nowhere near that kind of nuanced nomenclature with mental health.

You don't mention any previous incidents of depression, or a history of it in your family. So it sounds like you have situational, not clinic depression. This is not to diminish your problems in any way. But your fears that you might "spend the rest of your life feeling like this", may well be unfounded. You describe being in an anhedonic state. You feel isolated and have trouble finding enjoyment in the things you used to.

I have a close friend who sought treatment for depression after the breakup of her long term relationship who was described very similar feelings to what you have. It took her two months to find a therapist she liked, that was addressing the problems she was working through, and then another six months of therapy to start to return to normal. At her therapist's suggestion, she took antidepressants for a number of those months, and when things were improving, her therapist suggested she discontinue her medication. She felt that her episode of depression had been brought on by a traumatic life event, dealt with the underlying feelings and insecurities it had raised, and was able to return to functioning normally at an emotional level.

Now, perhaps as you suggest, medication is absolutely not an option for you. There are many other great suggestions here for how to treat the symptoms you feel for now, some of them may work, others probably not. Especially if you're having true anhedonic problems of lack of positive emotional response to the things which used to work.

I would echo the calls to find a social outlet or a community. I also understand the difference between a walking culture like New York's moving to a driving culture like California. It's just isolating in comparison.

Think about willpower fatigue. Imagine you have an allocated amount of willpower in a given day, and when you're feeling depressed, that amount is extremely low. Try to compensate for that. If you've been thinking of going to a meet up group, pick one that isn't on a work day where you've already used up so much that dragging yourself out of the house is going to be a major hurdle. Try to find something on a weekend afternoon, or a time where you're in the best position to plan ahead and stick to that commitment.

This is a long winded way to say, things will get better with time, which is ****ing cold comfort in the moment, but look after yourself and find ways to feel a greater connection in your new city and it will make things easier, even if getting to that place will take work and planning.
posted by linus587 at 7:52 AM on September 22, 2014 [2 favorites]

Best answer: Here's the thing, from your posts I get the impression you are an intelligent problem-solver, who is good at caring for others.
So, 1. Physician, heal thyself.

I've found that if I'm getting stuck on fixing my own problems, it's because I'm holding myself back. If you were someone else, giving advice to yourself, or to colleague in the same situation, what would you suggest doing? Just, straight up, off the bat?
What if this was a strangers metafilter post? (Ironically, just like that other post you replied to).
At what point would you tell yourself/this 'colleague' to go ahead, try medications?
Cut off contact with an ex-boyfriend when it's making you miserable?
Work out what your NEEDS are, and start meeting them, even if it doesn't make you feel better right away. (Treatment may take 2-4 weeks to be effective!).

Now, you've probably worked up a lot of justifications and excuses about why you couldn't try those things (you're smart, right? Brains are good at that).
2. Get out of your own way.
Treat your problems like someone elses problems. Come up with some possible 'fixes', and then try them. Ignore the justifications that you use to escape doing anything, especially ones that you know you wouldn't accept from someone else. Just go ahead, try it.
They won't work instantly. Pushing your comfort envelope may feel uncomfortable, but you can still feel proud of yourself that you took your dog out on a beautiful day - is there a part of yourself that, even though it felt awkward and uncomfortable, is proud that you didn't stay inside at home for the day?

It sounds like you're good at doing the tough things, but, possibly mostly for other people? Try doing the tough things for yourself.
Or, if that is too hard (I'm not kidding, I find it far easier to do things for other people), figure out the things you need to do for yourself, then find a way to involve other people in it. Seriously, if you can't get yourself along for a massage, then tell a friend that you're taking them out for a treat, and get two. Figure out what motivates you - not your friends, your neighbours, your ex, your colleagues, but you.
posted by Elysum at 3:15 PM on September 22, 2014 [1 favorite]

Response by poster: Thank you so much, everyone, for the thoughtful, caring, and insightful answers. Even though this is the Internet and I don't know any of you in "real" life, this has made me feel a little less alone. I will go and talk to my therapist about antidepressants - maybe you're all right, I need to be on them for a little while so I that I can pull myself out of this dark place im in. And the other comments - about how my greatest issue right now seems to be that I don't feel a sense of belonging, a deep connection - I think that really hit the nail on the head. I think that's exactly my issue, my biggest issue probably, outside of the depression. I'm going to try and do some more self-reflecting to try and figure out how to fix that. Ursula, you're right - I AM free, in a way I've never been before, and thats absolutely terrifying but I also need to figure out how to work with that freedom and take advantage of it to build some kind of life for myself. I've felt so stuck this past year - like i've just hit a wall that I can't get past... And I meed to get past it. And in the meantime I'm going to completely stop talking to my ex - both of them - and try meds. Thank you all again so much... I'll write an update post if/when things get better.
posted by nightdoctress at 3:52 AM on September 23, 2014 [4 favorites]

Operationally, strange as it may sound, try taking pictures? It's quick, it's easier than having a go at a short story or taking a class, it summons up some creativity, can feel productive in that you've artistically captured a moment, even basic editing programs bring another element of creativity into it, it can be fun to share them, you can have a picture a day of your dog (and you might be glad to have them in the shorter- and longer-term future).
posted by ambient2 at 10:45 PM on September 29, 2014 [1 favorite]

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